Rapid Change

Learning Package

Enablers for rapid improvements

across health and social care

Context Driver

Diagram Observed Enablers

Find Out More

Get Involved

Purpose of this learning package

During the current crisis, delivering improvements

across health and social care has become

increasingly fast paced.

Working in new environments and faced with

increasing pressures staff are

• finding new ways to do things

•having to make important decisions quickly and

•dealing with the emotional impact on themselves

and others

This learning package attempts to capture the key

factors that have been observed as enablers of

rapid improvements across health and social care

processes, organisations and systems during the

COVID-19 crisis.

The learning package is offered to demonstrate

how staff have adapted improvement theory

approaches to meet the pace of

change whilst ensuring that changes

to practice stay safe, effective

and help to save lives.

What is in this learning package?

This learning package is structured around a driver

diagram which provides a theory of change with

the specific aim to

“enable rapid improvements across health and

social care using observed learning from the

COVID19 crisis”

The following pages include

• a driver diagram

• a guide to each observed enabler

• links to examples from practice

This learning package is intended to be dynamic

and evolving to create a change package - but we

need you to Click on the link to

find opportunities to update examples and share

your experiences, observations and learning.

You can navigate this document using the

chevron links at the top of each page, via the

arrows at the bottom right corner or by clicking on

individual drivers.

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Context Driver

Diagram Observed Enablers

Find Out More

Get Involved

Get Involved

Knowledge &

Capability

To enable rapid improvements across health

and social care using observed learning from the COVID19

crisis

Trust &

Engagement

Communication

fdfg Subject Matter Experts being able to share issues they are

seeing/ experiencing

fdfg Knowledge and capability of testing solutions which will help

address the issues/problems

fdfg Knowledge and capability of using relevant QI methodology in

the current environments

fdfg To share learning immediately across wards, departments and

Trusts

fdfg To ensure all information is up to date, accurate and relevant

fdfg Team cohesiveness to share knowledge and learning on a

regular basis

fdfg Willingness to collaborate, change practices together; sharing

successes and failures to learn from as a team

fdfg To create a psychologically safe space in which all staff are

listened to

fdfg To use social media (accessible platforms) to quickly

communicate learning to a wider audience

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Context Driver

Diagram Observed Enablers

Find Out More

Get Involved

Next Previous

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• Frontline staff are recognised as the subject matter experts; having them at the heart of all

processes is required for designing, testing, learning, and spreading change in rapid timescales

• Gaining and extracting knowledge of the everyday (every hour?) issues and problems faced by

staff and patients from subject matter experts helps solve the right problems with sustainable

solutions

• Staff are trusted to make decisions; barriers to decision making (committees etc) are reduced

Context Driver

Diagram Knowledge

& Capability Find Out

More Get

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• Using QI methodology, tools, and techniques to help redesign or create new processes,

pathways, and systems, efficiently and effectively.

• Ensuring as many staff as possible are informed and engaged in the process with a clear

objective shared, which may very well change quite quickly.

• Organisations with embedded continuous approaches to QI are driving change; thinking with a QI

lens, not using as a project based tool;

BMJ

Clinical

leaders

article

COVID

Doc

Roberts

blog

QI

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Tweet

PDSA

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blog

Role

of QI

blog

• Having a clear and agreed aim supports staff to work towards generating potential solutions

• Tests of change start on a small scale, recorded and shared, building up quickly via PDSA cycles.

This maintains the first principle of change in that we do no harm; maintaining minimal risk

• Using PDSAs and scientific thinking rigorously and robustly to support quick and effective learning

• Allowing space and time for staff to reflect and study the learning so effective decisions can be

made based on data and their knowledge and experiences

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• Teams are informed regularly of the changes being tested, adopted, and implemented with a clear

and succinct method sharing learning to reduce inconsistent practice and non-standardised

processes.

• Teams learn together and share both knowledge and experience in an environment that promotes

openness and honesty; adopting flat hierarchy, horizontal leadership, and empowering everyone

• Ensuring everyone in the team is capable of adopting new practice and are supported in an

environment of ambiguity and uncertainty.

Context Driver

Diagram Trust &

Engagement Find Out

More Get

Involved

• Staff are agile and work together, breaking down previous barriers to collaborate across

departments, wards, trusts, care agencies.

• Where the rapid pace is generating changes multiple changes, teams are valued and engaged to

support and test new ways of working ensuring they are part of the process, empowered

throughout

• Creative and innovative ideas of change and new ways of working are encouraged

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• Staff are enabled to take time out and look after their health and well being in a very new and ever

changing and stressful environment

• Staff feel valued for their knowledge and experiences by being able to voice ideas, express

concerns and celebrate success in a supportive environment

• Briefings are succinct and supportive of what staff require after long stressful shifts

Changing

Culture

Tweet

Enable

Emergent

Learning

Article

Finding

a New

Normal

Blog

Wobble

Rooms

Tweet

BMJ

Compassion

Blog

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Black Box

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• Real time learning is collated and fed back into the system in a brief and digestible manner to

ensure its uptake

• Learning is shared (internally and externally) throughout the process. we learn from each others’

tests of change, knowledge, and experience; less time for producing journals and research

papers

Context Driver

Diagram Comms

Find Out More

Get Involved

• There are an increasing number of platforms to share learning and knowledge

• Real time sharing on Twitter has and continues to be a source of learning and a way of

collaborating with other professionals around the globe

• With many services facing similar challenges within the health and social care system (eg

communicating effectively while wearing PPE / running virtual clinics) using social media is a

quick way of learning from others and forming working relationships without boundaries

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• Changes across health and social care are occurring at great speed and any information shared

needs to be accurate and up to date with a pre-requisite that this may well change very quickly as

more evidence and data develops.

• As more services share similar ideas and learning outcomes the evidence and data of its success

is growing increasing our confidence that this is a viable solution.

Sharing

Learning

Tweet

Innovation

and

Learning

Blog

Health

Foundation

Innovation

Article

Global

Learning

Tweet

Q

COVID-19

Resources

IHI

Lessons

from the UK

Nightingale

Next Previous

Context Driver

Diagram Observed Enablers

Find Out More

Get Involved

Knowledge &

Capability

Trust &

Engagement

Communication

PDSA

During the

COVID-19

Pandemic

Fighting

COVID-19

with

LEAN

AQuA Psychological

Safety/

Wellbeing

Huddle

Guidance

Communication

in

PPE

i-Hub

Sharing

Compassionate

Practice

AQuA Psychological

Safety/

Wellbeing

Huddle

Video

AQuA Psychological

Safety/

Wellbeing

Huddle

Guide

NHS

Practitioner

Health

IHI

Stories of the

COVID Crisis

IHI

Blogs and

Virtual

Learning

Warring ton

Hospital

“Black

Boxes”

Sky News

Changing

Practice

Pharmacy

Team

Tweet

Decision

Making

Article

IHI

Using QI

to Adapt

Blog

Patient

Safety

Learning

Hub

Coming

Soon

Coming

Soon

Coming

Soon

Context Driver

Diagram Observed Enablers

Find Out More

Get Involved

Work with us to sustain changes

that improve “business as usual”

Join the

discussion

on Twitter

#AQuAChangePackage

Capture your learning and share with the

learning community

Share ideas that are helping you to

embed rapid improvements

Sign up for one of our virtual rapid

change forums

Share your experiences and observations around the enablers

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Register your Interest Here

Context Driver

Diagram Observed Enablers

Find Out More

Get Involved

@AQuA_NHS

www.aquakx.co.uk

www.aquanw.nhs.uk

Contact us via

AQuA@srft.nhs.uk

#AQuAChangePackage

www.quest.nhs.uk